Arhinful Enoch, Rosenthal Andrew
Division of Trauma Services, Memorial Regional Hospital, 3501 Johnson St, Hollywood, FL 33021, USA.
Pediatr Emerg Care. 2009 Nov;25(11):764-8. doi: 10.1097/PEC.0b013e3181bec953.
A 17-year-old adolescent girl with no past medical history presented to the emergency department with a chief complaint of lower back pain after sustaining a minor fall several hours earlier. Physical examination revealed mild to moderate back tenderness, and the result of review of systems was negative. Laboratory evaluation was within reference limits, and plain radiograph of the thoracolumbar spine revealed mild scoliosis and irregularity at L1 vertebra. Subsequent imaging studies revealed a comminuted, burst fracture of L1 with 90% spinal canal compromise. Her management consisted of early surgical treatment, and she had a quick recovery. Her postoperative course was unremarkable. We present this case to emphasize the importance of a comprehensive history taking in young patients with complaints of back pain and to highlight the role of imaging studies in the evaluation of back pain and in the assessment for surgical or nonoperative management.
一名17岁既往无病史的青春期女孩因数小时前轻微跌倒后出现下背部疼痛为主诉就诊于急诊科。体格检查发现背部有轻至中度压痛，系统回顾结果为阴性。实验室检查结果在参考范围内，胸腰椎平片显示轻度脊柱侧弯和L1椎体不规则。随后的影像学检查显示L1椎体粉碎性爆裂骨折，椎管受压90%。她接受了早期手术治疗，恢复迅速。术后过程顺利。我们展示此病例以强调对主诉背痛的年轻患者进行全面病史采集的重要性，并突出影像学检查在背痛评估以及手术或非手术治疗评估中的作用。
